| NPI | 1952619959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11023301) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 4162) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 4162-33) | |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2024-11-08 |