| NPI | 1710657564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11015395) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11015395) |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2026-05-06 |