| NPI | 1679168561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11014009) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015895) |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2022-11-01 |