| NPI | 1689279010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11006655) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1015279) |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2020-12-03 |