| NPI | 1821648437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11001666) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11001666) |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2021-08-02 |