| NPI | 1023036456 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11021590) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 126546) | 
| Enumeration Date | 2006-07-17 | 
| Last Update Date | 2023-12-20 |