| NPI | 1124321088 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8039)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 004566)  | 
| Enumeration Date | 2010-12-15 | 
| Last Update Date | 2025-02-19 |