| NPI | 1942679303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11011702) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2021-02-25 |