| NPI | 1972191831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11010989) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 9371116) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN11010989) | |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2021-03-26 |