| NPI | 1063028850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11006182) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: FL 11006182) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: FL 11006182) | |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2023-08-30 |