| NPI | 1568955771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5016101) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 9370786) |
| 363L00000X Nurse Practitioner (Licence: FL ARNP9370786) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL F06180399) | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2022-05-16 |