| NPI | 1144331638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5006871) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9220879) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-10-17 |