| NPI | 1689969545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5984) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 115399030) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2015-01-08 |