| NPI | 1679364194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11041163) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9513470) |
| Enumeration Date | 2025-05-14 |
| Last Update Date | 2025-07-31 |