| NPI | 1912534231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 1912534231) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: FL 11006753) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: FL 11006753) | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2023-06-22 |