| NPI | 1366598203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R863813) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA APO4802) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2014-02-19 |