| NPI | 1295472090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11019667) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11019667) |
| Enumeration Date | 2022-05-13 |
| Last Update Date | 2024-01-29 |