| NPI | 1194274712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11011583) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP016519) |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2021-04-22 |