| NPI | 1952649642 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9264601) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARPN9264601) | 
| Enumeration Date | 2013-01-30 | 
| Last Update Date | 2025-07-22 |