| NPI | 1740250596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP1734A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 485780) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2019-02-08 |