| NPI | 1891139713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: SC 2012016606) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 2012021100) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2013-04-22 |