| NPI | 1558842245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9363460) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000025805) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2021-08-20 |