| NPI | 1104201995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP02724) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM NM74799) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2018-11-06 |