| NPI | 1568004612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11004161) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11004161) |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2019-10-30 |