| NPI | 1134545692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22351) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP013510) |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2019-01-16 |