| NPI | 1740586288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL aprn9179951) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL arnp9179951) |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2019-09-27 |