| NPI | 1578144457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11019028) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F04210205) |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2024-12-02 |