| NPI | 1821623646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11006719) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F03200328) |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2022-04-25 |