| NPI | 1477087104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11007316) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9360419) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2020-05-30 |