| NPI | 1104654862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11036048) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11036048) |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2026-06-02 |