| NPI | 1760609960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9204512) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN9204512) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 2007001598) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2019-12-09 |