| NPI | 1811743123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11032608) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9374334) |
| Enumeration Date | 2024-04-26 |
| Last Update Date | 2024-05-08 |