| NPI | 1982203915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11007879) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: FL APRN11007879) |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2022-03-15 |