| NPI | 1063513380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD 0306) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A132658) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2014-03-23 |