| NPI | 1932534823 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11011586)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9258252)  | 
| Enumeration Date | 2013-09-10 | 
| Last Update Date | 2025-01-11 |