| NPI | 1700530813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11017799) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9359403) |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2022-02-08 |