| NPI | 1013691815 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP033058)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL F03230027)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP001573)  | |
| Enumeration Date | 2023-06-12 | 
| Last Update Date | 2025-10-20 |