| NPI | 1861741159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP-1212A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1212A) |
| Enumeration Date | 2012-09-03 |
| Last Update Date | 2012-09-03 |