| NPI | 1730044926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11044007) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95037911) |
| Enumeration Date | 2025-12-19 |
| Last Update Date | 2026-01-22 |