| NPI | 1558617431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-127583) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-127583) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2012-11-02 |