| NPI | 1982417960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11037811) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F01250994) |
| Enumeration Date | 2025-01-31 |
| Last Update Date | 2025-07-21 |