| NPI | 1205105970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN2967152) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 2967152) |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2021-04-14 |