| NPI | 1134804750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11030491) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9583145) |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2025-03-19 |