| NPI | 1053860015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA sp019208) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174066) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2018-09-19 |