| NPI | 1023213162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 110895) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A-117058) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2015-05-14 |