| NPI | 1104179449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9233509) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9233509) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2021-03-24 |