| NPI | 1639210412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN9432283) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 150718) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: MO 150718) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2023-08-03 |