| NPI | 1386824522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MD RN107090) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: DC RN55311) |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2007-11-05 |