| NPI | 1710654983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11022631) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 0996733-NP) |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2024-08-30 |