| NPI | 1689202426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11015304) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 95034444) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2021-11-24 |