| NPI | 1922735695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11019980) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11019980) |
| Enumeration Date | 2022-08-03 |
| Last Update Date | 2022-08-25 |