| NPI | 1205206778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9296194) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9296194) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9296194) | |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2021-02-17 |