| NPI | 1154885804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002709) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9375253) |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2020-05-20 |