| NPI | 1912158601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5004123) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 113802) |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2015-08-25 |