| NPI | 1720423924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9285214) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9285214) |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2021-05-07 |