| NPI | 1679182943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11008242) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11008242) |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2021-06-10 |