| NPI | 1942802384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 0000000) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11010328) | |
| Enumeration Date | 2020-11-11 |
| Last Update Date | 2022-04-12 |