| NPI | 1215954862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP1289A) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: ID CHIA-1167) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2015-06-01 |