| NPI | 1619439874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002174) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 03190573) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2019-04-18 |