| NPI | 1174353080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11034850) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 00000) |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2024-10-29 |