| NPI | 1245988047 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11018437)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9318932)  | 
| 164W00000X Licensed Practical Nurse (Licence: FL 11018437)  | |
| Enumeration Date | 2022-03-11 | 
| Last Update Date | 2022-03-11 |