| NPI | 1780720094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN2777292) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN2777292) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2022-07-21 |