| NPI | 1164909339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112565) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA H152173) |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2018-09-20 |