| NPI | 1902350556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3010572) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: KY 1109689) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2016-08-12 |