| NPI | 1306100672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP06867) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R892477) |
| Enumeration Date | 2012-07-01 |
| Last Update Date | 2013-01-06 |