| NPI | 1861069866 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11013564) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11013564) | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11013564) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11013564) | |
| Enumeration Date | 2021-06-08 | 
| Last Update Date | 2021-06-08 |