| NPI | 1275614851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 110282) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 110282) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2012-10-01 |