| NPI | 1922497601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN9277710) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL RN9277710) |
| Enumeration Date | 2015-01-17 |
| Last Update Date | 2019-01-28 |