| NPI | 1679119986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11000739) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11000739) |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2020-12-28 |