| NPI | 1710494711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-148728) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-148728) |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2017-12-29 |