| NPI | 1659925550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11003702) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9380082) |
| 363L00000X Nurse Practitioner (Licence: FL APRN11003702) | |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2022-01-19 |