| NPI | 1619675311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11024928) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 2022001273) |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2023-02-24 |