| NPI | 1255159356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11031404) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL 11031404) |
| Enumeration Date | 2024-09-28 |
| Last Update Date | 2024-12-09 |