| NPI | 1689118259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11018591) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9400128) |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2022-04-01 |