| NPI | 1508174236 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9335882) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-087622) | 
| 363LF0000X Nurse Practitioner, Family (Licence: AL 1-087622) | |
| Enumeration Date | 2010-09-15 | 
| Last Update Date | 2022-07-21 |