| NPI | 1639228810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP1318812) |
| Additional Taxonomies | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: FL 1318812) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2013-03-19 |