| NPI | 1780058453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11012415) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5009055) |
| 363L00000X Nurse Practitioner (Licence: FL 0116420) | |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2023-09-06 |