| NPI | 1760981450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9231206) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL RN9231206) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2021-04-23 |