| NPI | 1659077394 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11021692) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11021692) | 
| Enumeration Date | 2023-02-03 | 
| Last Update Date | 2024-07-23 |