| NPI | 1417602087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11021101) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11021101) |
| 163W00000X Registered Nurse (Licence: FL 9487516) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL RN9487516) | |
| Enumeration Date | 2022-02-12 |
| Last Update Date | 2022-11-18 |