| NPI | 1154799104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL F1114452) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 2716362) |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2020-10-21 |