| NPI | 1225480858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112104) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 71888) |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2016-11-01 |