| NPI | 1053601815 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9286651)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4011863)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9286651)  | |
| Enumeration Date | 2011-04-13 | 
| Last Update Date | 2024-02-16 |