| NPI | 1669913448 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9236154) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9236154) | 
| Enumeration Date | 2017-03-14 | 
| Last Update Date | 2018-10-08 |