| NPI | 1093484263 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R38981) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND R38981) | 
| Enumeration Date | 2021-09-10 | 
| Last Update Date | 2023-01-09 |