| NPI | 1639883036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11024440) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 662466) |
| Enumeration Date | 2023-01-10 |
| Last Update Date | 2023-02-15 |