| NPI | 1639281314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9487306) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MO 081717) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 0336699-22) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-01-08 |