| NPI | 1366437907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 686) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC APN 686) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2012-06-25 |