| NPI | 1063218519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11038284) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL 678488) |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-04-15 |