| NPI | 1265219158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11028557) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9489089) |
| Enumeration Date | 2023-09-13 |
| Last Update Date | 2023-09-13 |