| NPI | 1366888463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9358164) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 75866) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2017-01-04 |