| NPI | 1992748784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 6744) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP007856) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2017-02-08 |