| NPI | 1508824699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN2116242) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 314100168) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0001251055) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2025-07-19 |