| NPI | 1184676025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9164847) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ARNP9164847) |
| 363L00000X Nurse Practitioner (Licence: FL 9164847) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-09-09 |