| NPI | 1467877209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9222820) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: FL 9222820) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9222820) | |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2022-01-24 |