| NPI | 1639931124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11030731) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL RN9338846) |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-08-02 |