| NPI | 1407697063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11033309) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 3-001802) |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2024-06-10 |