| NPI | 1104609619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11026888) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11026888) |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2026-02-25 |