| NPI | 1477804466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: WI 5072-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WI 5072-33) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2016-01-04 |