| NPI | 1285231761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11009695) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9387556) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9387556) | |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2020-11-04 |