| NPI | 1548587462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 208370) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9182275) |
| Enumeration Date | 2010-05-02 |
| Last Update Date | 2010-11-02 |