| NPI | 1972076099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11001018) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9398405) |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2024-05-16 |