| NPI | 1336832773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11026632) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA GAA-NP005017) |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2026-04-23 |