| NPI | 1821410366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0990960) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 1623577) |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2016-04-05 |