| NPI | 1740679752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 23611) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 5700-33) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ ap5014) | |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2015-01-14 |