| NPI | 1366812885 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9316017) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9316017) | 
| Enumeration Date | 2015-09-26 | 
| Last Update Date | 2018-05-17 |