| NPI | 1215668413 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 29366) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022022473) | 
| Enumeration Date | 2022-06-20 | 
| Last Update Date | 2025-05-28 |