| NPI | 1972061448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002589) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL RN9168307) |
| 363L00000X Nurse Practitioner (Licence: FL 11002589) | |
| 363L00000X Nurse Practitioner (Licence: FL APRN11002589) | |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2024-10-30 |