| NPI | 1760246672 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 29016)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5020860)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP002526)  | |
| Enumeration Date | 2024-02-12 | 
| Last Update Date | 2024-09-19 |