| NPI | 1083176366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11001052) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11001052) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11001052) | |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2021-02-17 |