| NPI | 1053784157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 21154) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 194208) |
| 363LF0000X Nurse Practitioner Family (Licence: VA 0024174365) | |
| Enumeration Date | 2015-11-11 |
| Last Update Date | 2017-02-01 |