| NPI | 1063953453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112192) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 112192) |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2018-05-22 |