| NPI | 1891447744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11017794) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F01220755) |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2023-10-27 |