| NPI | 1831704089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11021577) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP022357) |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2022-10-26 |