| NPI | 1336363613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-108363) |
| Additional Taxonomies | 171W00000X Contractor |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2015-09-08 |