| NPI | 1104394303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL RN9338618) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ARNP9338618) |
| Enumeration Date | 2018-11-06 |
| Last Update Date | 2019-09-09 |