| NPI | 1619217627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC R162531) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MD R162531) |
| Enumeration Date | 2013-02-27 |
| Last Update Date | 2013-09-24 |