| NPI | 1174175285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11002696) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11002696) |
| 163WG0000X Registered Nurse, General Practice (Licence: FL 9375941) | |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2019-08-06 |