| NPI | 1487085122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009075) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18612) |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2020-07-10 |