| NPI | 1154757151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11014502) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN APN0000017905) |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2021-09-17 |