| NPI | 1265428973 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9281840) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A092106) | 
| Enumeration Date | 2005-09-27 | 
| Last Update Date | 2020-09-14 |