| NPI | 1871991323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6262) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 191506) |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2015-03-03 |