| NPI | 1285085126 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112080)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 81990)  | 
| Enumeration Date | 2016-06-22 | 
| Last Update Date | 2019-01-29 |