| NPI | 1811371537 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R156597)  | 
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: MD R156597)  | 
| Enumeration Date | 2015-07-13 | 
| Last Update Date | 2015-07-13 |