| NPI | 1508981820 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 112038) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-02719) | 
| Enumeration Date | 2007-03-20 | 
| Last Update Date | 2024-01-08 |