| NPI | 1528672284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11009059) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F07201858) |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2021-10-06 |