| NPI | 1568948990 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-179653) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 24427) | 
| Enumeration Date | 2018-07-18 | 
| Last Update Date | 2021-03-05 |