| NPI | 1376103697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11000553) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11000553) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2020-01-16 |