| NPI | 1982052882 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95011288) | 
| Additional Taxonomies | 282NC0060X General Acute Care Hospital, Critical Access (Licence: NJ 26NJ00641300) | 
| Enumeration Date | 2016-06-01 | 
| Last Update Date | 2019-07-09 |