| NPI | 1306336698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9322158) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9322158) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2020-11-08 |