| NPI | 1083292148 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 28160)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC MCCA-8RoC7)  | 
| Enumeration Date | 2021-03-31 | 
| Last Update Date | 2024-05-06 |