| NPI | 1811563968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11013126) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9380374) |
| Enumeration Date | 2021-05-31 |
| Last Update Date | 2024-10-18 |