| NPI | 1881698306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 2317) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA 095411) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2015-09-21 |