| NPI | 1780669572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5008494) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP727382) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2016-12-07 |