| NPI | 1578812038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL A0312081) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-053151) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2015-09-17 |