| NPI | 1629581426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL AG10170094) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL AG10170094) |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2020-09-23 |