| NPI | 1659335917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 109723) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 1622) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2019-01-10 |