| NPI | 1184388647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11015975) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: FL 11015975) |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2021-11-01 |