| NPI | 1366052003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11009133) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL F08200207) |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2021-05-24 |