| NPI | 1780074682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9348007) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 9348007) |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2019-01-09 |