| NPI | 1245636067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9207422) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9207422) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2020-05-21 |