| NPI | 1336560184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9168930) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9168930) |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2019-06-05 |