| NPI | 1124760939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11019140) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F04220178) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-04-23 |