| NPI | 1861220097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11048716) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9650473) |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2026-06-30 |