| NPI | 1104425669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11012949) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL F09200327) |
| Enumeration Date | 2020-10-25 |
| Last Update Date | 2023-05-16 |