| NPI | 1003418138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11012953) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.021713) |
| Enumeration Date | 2020-11-13 |
| Last Update Date | 2024-08-13 |