| NPI | 1760573778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R851902) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-076308) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2007-07-08 |