| NPI | 1801144134 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 19475) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2012014765) | 
| Enumeration Date | 2012-08-16 | 
| Last Update Date | 2021-06-04 |