| NPI | 1861810897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 32830.1278) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 2013013397) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2015-04-20 |