| NPI | 1154895514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11001372) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11001372) |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2022-03-17 |