| NPI | 1740777804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11019713) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 23194) |
| Enumeration Date | 2018-04-15 |
| Last Update Date | 2022-12-19 |