| NPI | 1134545692 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22351) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP013510) | 
| Enumeration Date | 2014-03-07 | 
| Last Update Date | 2025-04-18 |