| NPI | 1770279200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11025686) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL RN9513866) |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2024-02-22 |