| NPI | 1699420521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11026016) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 226583) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA 226583) | |
| Enumeration Date | 2022-02-18 |
| Last Update Date | 2023-06-15 |