| NPI | 1962929315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9212606) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 9212606) |
| Enumeration Date | 2017-08-26 |
| Last Update Date | 2022-01-12 |