| NPI | 1801129895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9405066) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209008258) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2020-01-09 |