| NPI | 1639700503 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11016034)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 23574)  | 
| Enumeration Date | 2020-01-30 | 
| Last Update Date | 2023-09-21 |