| NPI | 1063010643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11009743) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F09201512) |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2023-04-26 |