| NPI | 1669097820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11007494) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11007494) |
| 363LF0000X Nurse Practitioner Family (Licence: FL 11007494) | |
| Enumeration Date | 2020-06-13 |
| Last Update Date | 2024-02-05 |