| NPI | 1598207805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9180964) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9180964) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2021-03-17 |