| NPI | 1629174636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 2773) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP2970912) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2010-12-28 |