| NPI | 1154713220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19345) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 56910) |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2015-03-25 |