| NPI | 1609663202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11039091) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11039091) |
| Enumeration Date | 2025-04-24 |
| Last Update Date | 2025-10-17 |