| NPI | 1508383407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 3235012) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 80673) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2020-09-04 |