| NPI | 1104695071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11030220) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9304243) |
| Enumeration Date | 2023-12-20 |
| Last Update Date | 2023-12-20 |