| NPI | 1386140770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112481) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 68085) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-06-20 |