| NPI | 1558817684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN9298919) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: FL 9298919) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2021-01-10 |