| NPI | 1588130074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112646) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NE 112646) |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2019-03-20 |