| NPI | 1720758139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11015413) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN11015413) |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2023-01-13 |