| NPI | 1720769755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11027801) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11027801) |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2024-01-26 |