| NPI | 1770104705 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11020409) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9526021) | 
| 251B00000X Case Management (Licence: FL 100519) | |
| Enumeration Date | 2020-04-30 | 
| Last Update Date | 2025-04-28 |