| NPI | 1851712707 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 278491) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 1624559) | 
| Enumeration Date | 2013-12-19 | 
| Last Update Date | 2023-03-06 |