| NPI | 1760462626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 1711033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 47229) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2014-10-02 |