| NPI | 1265622849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP01324) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM R55046) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2019-08-21 |