| NPI | 1700294238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11004270) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP014043) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2023-08-03 |