| NPI | 1306932033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 212322) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 212322) |
| 363LF0000X Nurse Practitioner, Family (Licence: MS R855681) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-10-14 |