| NPI | 1225572993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11020012) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9280660) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174279) | |
| 163W00000X Registered Nurse (Licence: VA 0001255165) | |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2026-09-06 |