| NPI | 1275232829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11026483) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F02230583) |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2023-06-13 |