| NPI | 1700772092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11037231) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9494845) |
| 363L00000X Nurse Practitioner (Licence: FL 1103722) | |
| Enumeration Date | 2025-06-14 |
| Last Update Date | 2026-01-22 |