| NPI | 1598266777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9304026) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 2017028726) |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2021-11-15 |