| NPI | 1134016207 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 30574) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 247924) | 
| Enumeration Date | 2025-06-21 | 
| Last Update Date | 2025-08-09 |