| NPI | 1336537299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 100807) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 38130) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2020-01-09 |