| NPI | 1003269978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112097) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 65360) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2016-09-23 |