| NPI | 1942869094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11002679) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN10002679) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2020-09-09 |