| NPI | 1659335214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 116725) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 1810) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2010-06-11 |