| NPI | 1972277622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11011081) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL F12200547) |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2021-10-09 |