| NPI | 1972055218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: FL APRN9298689) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 9298689) |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2021-08-11 |