| NPI | 1043861586 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 113022)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 72654)  | 
| Enumeration Date | 2019-09-26 | 
| Last Update Date | 2019-11-14 |