| NPI | 1578057691 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R177992)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R17792)  | 
| Enumeration Date | 2018-06-21 | 
| Last Update Date | 2024-12-19 |