| NPI | 1194136119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A118347) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 118347) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-06-24 |