| NPI | 1942642004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11012219) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17791) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2022-07-15 |