| NPI | 1568758829 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019006675) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 149732) | 
| 363LF0000X Nurse Practitioner, Family (Licence: TN APN154784) | |
| Enumeration Date | 2011-06-24 | 
| Last Update Date | 2025-05-05 |