| NPI | 1649780990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: FL 9220819) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 9220819) |
| Enumeration Date | 2017-10-01 |
| Last Update Date | 2021-07-19 |