| NPI | 1063783744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: AL 1-062972) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: AL 1-062972) |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2014-08-01 |