| NPI | 1679149116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11003826) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9402210) |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2026-01-21 |