| NPI | 1487960373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 3211) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-112833) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2013-01-10 |