| NPI | 1134220692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9185928) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9185928) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2021-01-26 |