| NPI | 1912557539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9405295) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9405295) |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2019-09-16 |