| NPI | 1669491510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 2881-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 96781-030) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2017-11-14 |