| NPI | 1316308794 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 20001)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 20004)  | 
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: SC 20004)  | |
| Enumeration Date | 2016-03-14 | 
| Last Update Date | 2025-10-21 |