| NPI | 1265057798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN111010838) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F05200259) |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2021-01-18 |