| NPI | 1194084319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA AP05809) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA 05809) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2018-03-19 |