| NPI | 1700191798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4253) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 154598) |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2010-11-04 |