| NPI | 1023390937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN3411362) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 3411362) |
| Enumeration Date | 2011-09-16 |
| Last Update Date | 2019-11-12 |