| NPI | 1134666076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 6928) |
| Additional Taxonomies | 405300000X Prevention Professional (Licence: CT 6928) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2019-10-15 |