| NPI | 1962913699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9184158) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: FL RN9184158) |
| Enumeration Date | 2017-10-20 |
| Last Update Date | 2022-12-07 |