| NPI | 1053588848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5004573) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 237113) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 237113) | |
| 163W00000X Registered Nurse (Licence: NC 230797) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 230797) | |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2016-09-22 |