| NPI | 1255904744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11013892) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL 11013892) |
| Enumeration Date | 2021-07-21 |
| Last Update Date | 2022-06-27 |