| NPI | 1134518947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO 0991296) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 184144) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2015-05-29 |