| NPI | 1275983678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112056) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 74319) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2016-07-26 |