| NPI | 1417195959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011499) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: KY 111680) |
| 163W00000X Registered Nurse (Licence: TN 158773) | |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2020-08-21 |