| NPI | 1821633603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11016036) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9443496) |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2023-09-06 |