| NPI | 1659476166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: ID NP-621A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-621A) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2007-07-08 |