| NPI | 1063959203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9273729) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9273729) |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2025-03-13 |