| NPI | 1487954236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-100296) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 15663) |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2021-10-19 |