| NPI | 1629260732 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN979942) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 979942) | 
| Enumeration Date | 2007-08-13 | 
| Last Update Date | 2025-09-26 |