| NPI | 1154868024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112176) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 74152) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2017-02-06 |