| NPI | 1154827046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011364) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 303305) |
| 163WM0705X Registered Nurse Medical-Surgical (Licence: CT 123052) | |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2019-01-21 |