| NPI | 1104572445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11018702) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F02220103) |
| Enumeration Date | 2022-02-24 |
| Last Update Date | 2022-09-02 |