| NPI | 1154761021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A142336) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 111506) |
| 163W00000X Registered Nurse (Licence: NE 68917) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2016-11-10 |