| NPI | 1710766480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11025169) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61510679) |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2024-01-03 |