| NPI | 1457705220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 111980) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 63198) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2016-04-19 |