| NPI | 1598859688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2015044894) |
| Additional Taxonomies | 111NX0800X Chiropractor Orthopedic (Licence: MS 0391) |
| 363LF0000X Nurse Practitioner Family (Licence: MS R895367) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2017-10-12 |