| NPI | 1124316187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: RI npp37590) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: RI rn33601) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2013-10-28 |