| NPI | 1811180151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 110883) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 57585) |
| 363L00000X Nurse Practitioner (Licence: IA H-123323) | |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2020-01-22 |