| NPI | 1790189207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11010825) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11010825) |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2024-12-04 |