| NPI | 1104120021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9224200) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9224200) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9224200) | |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2019-03-29 |