| NPI | 1578228417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11016135) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9414323) |
| Enumeration Date | 2021-11-05 |
| Last Update Date | 2021-11-05 |