| NPI | 1649387572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 669) |
| Additional Taxonomies | 208800000X Urology (Licence: WI 58411) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2012-06-12 |