| NPI | 1215315486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA F0415126) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA 117232) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA 117232) | |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2015-10-05 |