| NPI | 1629261342 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 18163) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 5286P) | 
| Enumeration Date | 2007-08-27 | 
| Last Update Date | 2025-03-21 |