| NPI | 1619511672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11001226) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP035581) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP004049) | |
| Enumeration Date | 2019-11-03 |
| Last Update Date | 2026-03-18 |