| NPI | 1669095824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11007170) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F05200089) |
| Enumeration Date | 2020-05-22 |
| Last Update Date | 2022-05-19 |