| NPI | 1861165524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11012562) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11012562) |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2021-12-15 |