| NPI | 1619642030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11012983) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11012983) |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2024-10-14 |