| NPI | 1083499453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11027770) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5021470) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP031914) | |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 29756) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MD AC007335) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704425584) | |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2025-03-27 |