| NPI | 1033217575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200650163NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID N-14409 NP-207A) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-06-16 |