| NPI | 1003116567 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21675) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 241509) | 
| Enumeration Date | 2010-10-29 | 
| Last Update Date | 2025-06-30 |