| NPI | 1730678699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112486) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 77889) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2018-06-20 |