| NPI | 1063624096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA AP05150) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ANT9261578) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2013-10-17 |