| NPI | 1699378166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11010254) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 647109) |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2022-03-22 |