| NPI | 1992769509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 112284) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 1676) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2009-02-24 |