| NPI | 1386415867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11029405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP028941) |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2026-06-08 |