| NPI | 1548785611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112329) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 57042) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2017-09-07 |