| NPI | 1821762709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN11015740) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 202106466NP-PP) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 202106466NP-PP) | |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2022-05-24 |