| NPI | 1679211767 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11019325) | 
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: FL 14228) | 
| 163WX1500X Registered Nurse, Ostomy Care (Licence: FL 210278917S) | |
| Enumeration Date | 2022-05-26 | 
| Last Update Date | 2022-05-26 |