| NPI | 1992854848 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 1631) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 1631-033) | 
| Enumeration Date | 2007-01-09 | 
| Last Update Date | 2015-08-26 |