| NPI | 1578678835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9397212) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA APO4459) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2021-03-12 |