| NPI | 1700437894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11004327) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9290794) |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2019-10-23 |