| NPI | 1558030288 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-145580)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-145580)  | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-145580)  | |
| Enumeration Date | 2021-09-07 | 
| Last Update Date | 2023-02-23 |