| NPI | 1114491214 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL F09180409)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-148451)  | 
| Enumeration Date | 2019-01-11 | 
| Last Update Date | 2023-06-30 |