| NPI | 1457893158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112149) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 79454) |
| Enumeration Date | 2016-11-11 |
| Last Update Date | 2016-11-29 |