| NPI | 1578198842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9270968) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: FL 9270968) |
| Enumeration Date | 2020-03-07 |
| Last Update Date | 2020-12-18 |