| NPI | 1689215253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11004360) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: FL APRN11004360) |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2022-03-09 |