| NPI | 1710947726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 67813) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 222761) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2014-02-13 |