| NPI | 1194130419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5006937) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 209081) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2015-03-06 |