| NPI | 1023661311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11014678) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 56976) |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2025-02-12 |