| NPI | 1972652022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 868) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 57737) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2009-05-18 |