| NPI | 1346586757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A110802) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 111449) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2021-06-14 |