| NPI | 1366843120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007070) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 95986) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2016-04-27 |