| NPI | 1629121892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 80365) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 2255) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2009-11-04 |