| NPI | 1598361925 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11007665) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.026328) | 
| 363L00000X Nurse Practitioner (Licence: CA 95014786) | |
| Enumeration Date | 2020-12-10 | 
| Last Update Date | 2024-07-24 |