| NPI | 1548529167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-100942) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: AL 1-100942) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2016-08-05 |