| NPI | 1639461023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11029135) |
| Additional Taxonomies | 171W00000X Contractor (Licence: FL 000174302) |
| 171W00000X Contractor (Licence: FL 000174301) | |
| 171W00000X Contractor (Licence: FL 000174300) | |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2024-12-25 |