| NPI | 1508230921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9300008) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9300008) |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2023-01-19 |