| NPI | 1013225614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8118) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: MN 47) |
| 364S00000X Clinical Nurse Specialist (Licence: MN R167390-2) | |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2021-06-09 |