| NPI | 1912663360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11014798) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL 11014798) |
| Enumeration Date | 2021-11-10 |
| Last Update Date | 2021-11-29 |