| NPI | 1639994510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11036351) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9521110) |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2024-11-18 |