| NPI | 1407852387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP006924B) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: PA sp006924b) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2021-06-23 |