| NPI | 1053749226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07568) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA PA021807) |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2014-03-24 |