| NPI | 1790776441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP1042592) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 1042592) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2007-07-08 |