| NPI | 1588659635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A074340) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IA 074340) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2020-08-24 |