| NPI | 1396283677 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22511)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 95489)  | 
| Enumeration Date | 2017-02-07 | 
| Last Update Date | 2019-08-05 |