| NPI | 1134666712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 9362302) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9362302) |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-04-11 |