| NPI | 1548580509 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R867991)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 18717)  | 
| Enumeration Date | 2010-06-01 | 
| Last Update Date | 2023-03-07 |