| NPI | 1962174185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11015419) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11015419) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL RN9509344) | |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2023-01-11 |