| NPI | 1790156164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL aprn9199348) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9199348) |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2020-10-13 |