| NPI | 1487311023 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 227156)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN143398)  | 
| Enumeration Date | 2021-11-18 | 
| Last Update Date | 2022-12-08 |