| NPI | 1053769885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112045) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 69106) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: NE 112045) | |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2016-07-19 |