| NPI | 1073489969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11046371) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9603648) |
| Enumeration Date | 2025-10-16 |
| Last Update Date | 2026-03-26 |