| NPI | 1609283597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11001814) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 79075) |
| Enumeration Date | 2014-07-13 |
| Last Update Date | 2021-07-13 |