| NPI | 1164481396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NH 0312952303) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA 177806) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2012-03-13 |