| NPI | 1790792588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WI 76714) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 2576) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2007-07-08 |