| NPI | 1114689650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL F08210430) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL RN9479417) |
| Enumeration Date | 2021-10-12 |
| Last Update Date | 2021-10-12 |