| NPI | 1124744784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 11022420) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 9413666) |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2022-12-20 |