| NPI | 1760703110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9469591) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK 1152) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2021-04-27 |