| NPI | 1770352627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11028518) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: FL 11028518) |
| Enumeration Date | 2023-12-20 |
| Last Update Date | 2024-04-08 |