| NPI | 1104631407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11037608) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: FL 9591081) |
| Enumeration Date | 2025-02-12 |
| Last Update Date | 2025-02-12 |