| NPI | 1336348689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 140427) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 145658) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2012-06-25 |