| NPI | 1740553502 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9435185) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA AP06746) | 
| Enumeration Date | 2012-02-09 | 
| Last Update Date | 2024-08-20 |