| NPI | 1164937959 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11035203) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018217) | 
| Enumeration Date | 2017-12-03 | 
| Last Update Date | 2025-07-24 |