| NPI | 1730632704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9328517) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL V422559889630) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2019-10-09 |