| NPI | 1104397793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9395326) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN939526) |
| Enumeration Date | 2018-12-08 |
| Last Update Date | 2019-06-19 |