| NPI | 1629738539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11017004) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11017004) |
| Enumeration Date | 2021-12-20 |
| Last Update Date | 2021-12-20 |