| NPI | 1962992289 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11034677)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9418335)  | 
| Enumeration Date | 2018-05-11 | 
| Last Update Date | 2025-05-13 |