| NPI | 1124386636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9442755) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-049797) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2019-03-05 |