| NPI | 1962470310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 1634) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 61717) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2020-04-01 |