| NPI | 1558957100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11031605) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9510631) |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2025-12-16 |