| NPI | 1013485739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11000415) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9369566) |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2024-08-16 |