| NPI | 1043982705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11009965) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-175612) |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2023-07-07 |