| NPI | 1194446385 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11012623) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11012623) | 
| Enumeration Date | 2022-09-07 | 
| Last Update Date | 2023-03-13 |