| NPI | 1720214331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 2026982) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN2026982) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: FL APRN2026982) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2025-01-15 |