| NPI | 1134571003 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 7417) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A131370) | 
| Enumeration Date | 2016-07-05 | 
| Last Update Date | 2022-08-16 |