| NPI | 1700333770 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25024)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-143196)  | 
| Enumeration Date | 2016-09-07 | 
| Last Update Date | 2022-09-13 |