| NPI | 1073173142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11002837) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11002837) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11002837) | |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2022-08-02 |