| NPI | 1801675673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11030508) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F09230547) |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2024-10-11 |