| NPI | 1013529817 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11028387) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9432881) | 
| Enumeration Date | 2020-08-21 | 
| Last Update Date | 2023-09-05 |