| NPI | 1538665161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112494) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 79761) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2018-10-11 |