| NPI | 1639655889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9402754) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9402754) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2020-05-11 |