| NPI | 1063808004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9328410) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9328410) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2021-11-08 |