| NPI | 1538469689 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 229146) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS r864120) | 
| Enumeration Date | 2010-10-22 | 
| Last Update Date | 2023-07-25 |