| NPI | 1972716496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 9836853-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 13626) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2017-01-19 |