| NPI | 1073196499 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014386) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC WOOL-BB2MQ) | 
| Enumeration Date | 2021-05-03 | 
| Last Update Date | 2024-01-22 |