| NPI | 1306398375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112147) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 66825) |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2016-11-11 |