| NPI | 1265038715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11010432) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9270086) |
| 363L00000X Nurse Practitioner (Licence: FL APRN11010432) | |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2022-11-02 |