| NPI | 1164194569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11015492) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11015492) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11015492) | |
| Enumeration Date | 2021-10-04 |
| Last Update Date | 2024-06-04 |