| NPI | 1043798176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9400356) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 9400356) |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2019-02-13 |