| NPI | 1720624406 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11017050) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9424439) | 
| 363L00000X Nurse Practitioner (Licence: GA GAA-NP002170) | |
| Enumeration Date | 2019-11-18 | 
| Last Update Date | 2025-10-22 |