| NPI | 1508861238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NC 275611) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: FL 1005322) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2016-02-17 |