| NPI | 1780301374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11022606) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: FL 11022606) |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2025-08-21 |