| NPI | 1134678808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 9017774) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 866178) |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2016-11-15 |