| NPI | 1831842202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11016257) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 3-001448) |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2023-10-18 |