| NPI | 1528587847 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A102421) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA 102421A) | 
| Enumeration Date | 2017-09-18 | 
| Last Update Date | 2024-05-23 |