| NPI | 1356956403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11008198) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11008198) |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2021-02-12 |