| NPI | 1902533565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11020657) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: FL 9315879) |
| 363L00000X Nurse Practitioner (Licence: FL 11020657) | |
| Enumeration Date | 2022-08-03 |
| Last Update Date | 2023-04-18 |