| NPI | 1972144467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112891) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11003341) |
| Enumeration Date | 2019-10-05 |
| Last Update Date | 2019-10-05 |