| NPI | 1730759531 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2021024182) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95018025) | 
| Enumeration Date | 2021-06-25 | 
| Last Update Date | 2022-08-06 |