| NPI | 1548445505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11008170) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ4427) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2021-09-23 |