| NPI | 1639593940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9347002) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 9347002) |
| Enumeration Date | 2014-02-06 |
| Last Update Date | 2015-03-02 |