| NPI | 1780137422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL aprn11012326) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 171235) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2023-02-06 |