| NPI | 1790263853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9366873) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9366873) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2019-10-18 |