| NPI | 1760145924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11015990) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1110846) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP001188) | |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2025-10-21 |