| NPI | 1598361925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11007665) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95014786) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.026328) | |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2026-08-11 |