| NPI | 1093056483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 111473) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A089499) |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2017-05-06 |