| NPI | 1275947608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 111706) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA H137205) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2016-04-21 |