| NPI | 1740765130 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11000472)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9370029)  | 
| Enumeration Date | 2018-10-01 | 
| Last Update Date | 2025-07-29 |