| NPI | 1730720657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11004982) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11004982) |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2022-06-27 |