| NPI | 1629811286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11034204) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0041179) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 29470) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 363L00000X Nurse Practitioner (Licence: FL 11034204) | |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2026-01-21 |