| NPI | 1386005619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP015360) |
| Additional Taxonomies | 163WG0100X Registered Nurse Gastroenterology (Licence: PA SP015360) |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2017-02-23 |