| NPI | 1891447884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 2021035595) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9525899) |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2022-01-21 |