| NPI | 1790803278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R850198) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN099890) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2019-09-05 |