| NPI | 1609347129 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 22208) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1206561) | 
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN10031958) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KS TMP-163115) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5020409) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2025034147) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A186329) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11033960) | |
| 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP002438) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH 023129) | |
| Enumeration Date | 2018-12-10 | 
| Last Update Date | 2025-10-23 |