| NPI | 1164024030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11010362) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11010362) |
| 163W00000X Registered Nurse (Licence: FL 9428939) | |
| Enumeration Date | 2020-11-14 |
| Last Update Date | 2022-12-06 |