| NPI | 1700164035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9296563) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F07161084) |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2022-05-06 |