| NPI | 1386251379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11009444) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 646234) |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2022-12-16 |