| NPI | 1093115289 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 5340135-4405) | 
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: UT 5340135-3102) | 
| 363L00000X Nurse Practitioner (Licence: UT 5340135-4405) | |
| Enumeration Date | 2014-08-26 | 
| Last Update Date | 2023-01-20 |