| NPI | 1174939219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 22248) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: SC 217075) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2019-10-14 |