| NPI | 1568871150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 18992) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 20289) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2017-01-01 |