| NPI | 1891229787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NE 112217) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 74675) |
| 363LF0000X Nurse Practitioner, Family (Licence: NE 112217) | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2018-05-24 |