| NPI | 1376529180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 110090) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 28524) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2009-12-14 |