| NPI | 1336923812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11028260) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11028260) |
| Enumeration Date | 2023-08-24 |
| Last Update Date | 2023-11-14 |