| NPI | 1629857982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11028788) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11028788) |
| Enumeration Date | 2023-09-26 |
| Last Update Date | 2023-12-07 |