| NPI | 1912636366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11020060) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9489606) |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2024-01-02 |