| NPI | 1811523103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: FL APRN11003705) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 11003705) |
| Enumeration Date | 2020-03-18 |
| Last Update Date | 2023-08-18 |