| NPI | 1003396714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN9320665) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9320665) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2019-03-28 |