| NPI | 1316295330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9282374) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2012-08-23 |
| Last Update Date | 2021-08-13 |