| NPI | 1487030987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9461715) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9461715) |
| 363LF0000X Nurse Practitioner, Family (Licence: MS R881264) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MS r881264) | |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2018-05-09 |