| NPI | 1962088047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11011868) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11011868) |
| Enumeration Date | 2021-03-20 |
| Last Update Date | 2021-12-06 |