| NPI | 1316507049 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A156470) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ F05190456) | 
| Enumeration Date | 2019-06-14 | 
| Last Update Date | 2023-10-24 |