| NPI | 1164681714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 110937) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A091279) |
| Enumeration Date | 2008-06-07 |
| Last Update Date | 2019-12-18 |