| NPI | 1700479235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11016709) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180002) |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2022-02-23 |