| NPI | 1952628596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: HI APRN 1281) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 285331) |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2010-08-10 |