| NPI | 1467715763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ AP4960) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: ND R27639) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2019-02-12 |