| NPI | 1215652516 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 3-001076)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9590056)  | 
| Enumeration Date | 2022-10-10 | 
| Last Update Date | 2023-01-13 |