| NPI | 1538704580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN11005118) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL RN9363418) |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2019-11-18 |