| NPI | 1124598834 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11012596) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95010432) | 
| Enumeration Date | 2018-11-26 | 
| Last Update Date | 2023-07-11 |