| NPI | 1871129569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11031181) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11031181) |
| Enumeration Date | 2020-03-13 |
| Last Update Date | 2024-04-12 |