| NPI | 1649694183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS R859946) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS R859946) |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2015-09-02 |