| NPI | 1669755963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: WI 4614-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 165118-30) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2011-10-02 |