| NPI | 1174902852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9445274) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 19459) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2019-04-15 |