| NPI | 1902785157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11042923) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9666491) |
| Enumeration Date | 2025-09-01 |
| Last Update Date | 2025-10-14 |