| NPI | 1578821476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11014644) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170087) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9359115) | |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2022-07-11 |