| NPI | 1881797462 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A-122356)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ND R19389)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: WI 4055)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 2536)  | |
| Enumeration Date | 2006-09-07 | 
| Last Update Date | 2025-03-28 |