| NPI | 1790384196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11034579) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1109295) |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2026-04-30 |