| NPI | 1417639279 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA F06212587)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0012653)  | 
| Enumeration Date | 2023-08-02 | 
| Last Update Date | 2024-04-17 |