| NPI | 1457641169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 111726) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A141030) |
| 363L00000X Nurse Practitioner (Licence: MO 2011007921) | |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2019-10-30 |