| NPI | 1063848349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-02260) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM RN-6916) |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2013-09-18 |