| NPI | 1801569454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11047040) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 29815) |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2026-05-21 |