| NPI | 1255803649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11003065) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN11003065) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11003065) | |
| Enumeration Date | 2018-12-22 |
| Last Update Date | 2019-10-07 |