| NPI | 1609335744 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22568) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011591) | 
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11037798) | |
| Enumeration Date | 2019-03-18 | 
| Last Update Date | 2025-02-19 |