| NPI | 1851579742 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A177718)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 128272)  | 
| Enumeration Date | 2008-02-04 | 
| Last Update Date | 2025-06-02 |