| NPI | 1700028099 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9417992) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R144887) | 
| Enumeration Date | 2009-04-01 | 
| Last Update Date | 2025-08-13 |