| NPI | 1164155339 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 13180) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 157041) | 
| Enumeration Date | 2022-07-06 | 
| Last Update Date | 2022-09-28 |