| NPI | 1821855537 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11032705) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9540167) | 
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11032725) | |
| Enumeration Date | 2024-02-29 | 
| Last Update Date | 2025-03-06 |