| NPI | 1598152886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009046) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 196176) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2017-03-03 |