| NPI | 1366952251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9337637) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 0993433) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2018-11-15 |