| NPI | 1184938540 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9167001)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9167001)  | 
| Enumeration Date | 2010-07-28 | 
| Last Update Date | 2016-08-31 |