| NPI | 1134496235 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9216711) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9216711) | 
| Enumeration Date | 2011-11-18 | 
| Last Update Date | 2015-03-30 |