| NPI | 1942773106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11010365) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9411855) |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2021-05-14 |