| NPI | 1053954891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: FL 11004740) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11004740) |
| Enumeration Date | 2019-10-24 |
| Last Update Date | 2022-11-29 |