| NPI | 1326765561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11020492) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 0101832) |
| Enumeration Date | 2022-10-27 |
| Last Update Date | 2025-12-02 |