| NPI | 1598121220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19659) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008608) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2016-09-02 |