| NPI | 1184304693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11028514) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82479-011) |
| 163W00000X Registered Nurse (Licence: FL RN9503165) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2023035577) | |
| Enumeration Date | 2023-07-19 |
| Last Update Date | 2025-10-07 |