| NPI | 1013802339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11040795) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F065250062) |
| Enumeration Date | 2025-06-09 |
| Last Update Date | 2025-08-10 |