| NPI | 1891844007 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11018012) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 1006) | 
| Enumeration Date | 2007-01-09 | 
| Last Update Date | 2022-11-22 |