| NPI | 1053543504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN3221522) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 3221522) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2019-05-30 |