| NPI | 1639951528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND 200494) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11029002) |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2024-10-01 |