| NPI | 1750364428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP04759) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA PA 020646) |
| Enumeration Date | 2005-11-27 |
| Last Update Date | 2014-01-10 |