| NPI | 1306558077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11023946) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL RN9415416) |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2024-04-30 |