| NPI | 1164158010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11020977) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F07221251) |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2022-09-12 |