| NPI | 1114678257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11017532) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 2021117108) |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2022-03-31 |