| NPI | 1255780417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112102) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 75507) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2016-08-12 |