| NPI | 1255343349 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9318582) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9318582) | 
| 363L00000X Nurse Practitioner (Licence: IL 2090280069) | |
| Enumeration Date | 2006-08-13 | 
| Last Update Date | 2025-09-18 |