| NPI | 1558957100 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11031605) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9510631) | 
| Enumeration Date | 2020-12-17 | 
| Last Update Date | 2024-07-16 |