| NPI | 1568071389 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11014662)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 9015)  | 
| Enumeration Date | 2020-07-28 | 
| Last Update Date | 2023-05-01 |