| NPI | 1073148672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11006717) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL PENDING) |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2021-06-15 |