| NPI | 1386060929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11027260) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 18432) |
| 363LF0000X Nurse Practitioner, Family (Licence: MS A810574) | |
| Enumeration Date | 2014-03-06 |
| Last Update Date | 2023-08-18 |