| NPI | 1295102440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11045288) |
| Additional Taxonomies | 374700000X Technician (Licence: FL N5F2Y8M3) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2026-02-19 |