| NPI | 1063035368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11006663) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11006663) |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2023-01-04 |