| NPI | 1013651215 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11019382) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11019382) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-24 | 
| Last Update Date | 2025-04-15 |