| NPI | 1073160883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11003809) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 11003803) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2021-09-13 |