| NPI | 1285650515 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 000341)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 121)  | 
| Enumeration Date | 2006-07-13 | 
| Last Update Date | 2023-09-03 |