| NPI | 1134755002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: FL F03200149) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: FL 9366635) |
| Enumeration Date | 2020-03-22 |
| Last Update Date | 2022-07-21 |