| NPI | 1255720421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 19352) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 155239) |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2016-03-04 |