| NPI | 1104546019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11022230) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 2022045349) |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2022-11-15 |