| NPI | 1003503129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL AAPRN11027126) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9511504) |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2024-06-26 |