| NPI | 1336772474 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL APRN11005934) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN11005934) | 
| Enumeration Date | 2020-02-18 | 
| Last Update Date | 2020-03-05 |