| NPI | 1275142358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11007905) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11007905) |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2020-10-13 |