| NPI | 1104124064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP3394912) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN3394912) |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2019-12-18 |