| NPI | 1730979675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 2771653) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11039380) |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-05-12 |