| NPI | 1043595796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2011032581) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NM CNP-02537) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2014-10-27 |