| NPI | 1801483821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11010403) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL 11010403) |
| Enumeration Date | 2020-12-23 |
| Last Update Date | 2021-12-23 |