| NPI | 1326234634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007414) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 20872) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024166105) | |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2019-08-12 |