| NPI | 1316136039 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA 088939)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP05310)  | 
| Enumeration Date | 2007-10-18 | 
| Last Update Date | 2023-12-18 |