| NPI | 1588614903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0990397) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NN08653600) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2019-01-07 |