| NPI | 1750090569 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA F08220260)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA NP265302)  | 
| Enumeration Date | 2022-11-21 | 
| Last Update Date | 2025-10-07 |