| NPI | 1548956493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11024961) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN11024961) |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2024-02-23 |