| NPI | 1376943803 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 5980-33) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 174355) | 
| Enumeration Date | 2014-09-03 | 
| Last Update Date | 2023-02-10 |