| NPI | 1518526649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5011870) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 291430) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2019-06-17 |