| NPI | 1003647041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11034198) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL F07240198) |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2024-09-04 |