| NPI | 1942608450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-137379) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-137379) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2015-01-13 |