| NPI | 1992259006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 290074) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 3145052) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2017-04-28 |