| NPI | 1194175554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11004502) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71006282A) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2020-03-11 |