| NPI | 1275144362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11006630) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 11006630) |
| 363LF0000X Nurse Practitioner Family (Licence: FL APRN11006630) | |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2021-05-26 |