| NPI | 1235980616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11047708) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 55849) |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2026-05-29 |