| NPI | 1639685266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9366533) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL arnp9366533) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: FL 9366533) | |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2021-10-08 |