| NPI | 1861728446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DC RN1018023) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704250499) |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2009-12-23 |