| NPI | 1417460544 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-084839)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-084839)  | 
| Enumeration Date | 2017-11-11 | 
| Last Update Date | 2021-12-26 |