| NPI | 1366952012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9357191) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL RN9357191) |
| Enumeration Date | 2017-10-09 |
| Last Update Date | 2019-10-01 |