| NPI | 1972125482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11007764) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9288809) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2020-06-24 |