| NPI | 1780941427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4824) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 154363) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2012-04-19 |