| NPI | 1609464130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9236954) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9236954) | |
| Enumeration Date | 2021-01-10 |
| Last Update Date | 2021-02-05 |