| NPI | 1114563301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11015255) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: FL 9435365) |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2021-10-28 |