| NPI | 1235535584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 005989) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: CT 5989) |
| Enumeration Date | 2014-11-14 |
| Last Update Date | 2017-03-27 |