| NPI | 1457966830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11007346) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11007346) |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2024-06-10 |