| NPI | 1265089098 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015210)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 22268A)  | 
| Enumeration Date | 2019-08-26 | 
| Last Update Date | 2023-05-26 |