| NPI | 1831421221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 27795.1037) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 110024) |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2010-02-09 |