| NPI | 1609429794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11003274) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11003274) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-08-28 |