| NPI | 1265859938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 111274) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18734) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2015-09-30 |