| NPI | 1891939906 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 3730) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 61603-030) | 
| Enumeration Date | 2009-04-21 | 
| Last Update Date | 2018-10-16 |