| NPI | 1790411312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11021049) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL AG07220172) |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2025-05-01 |