| NPI | 1174914618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9283023) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9283023) |
| 163W00000X Registered Nurse (Licence: FL RN9283023) | |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2015-03-06 |