| NPI | 1366969677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112328) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 75532) |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2019-01-11 |