| NPI | 1568792893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9348138) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 14321) |
| Enumeration Date | 2010-01-08 |
| Last Update Date | 2014-07-16 |