| NPI | 1902275480 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 26162) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 6279) | 
| Enumeration Date | 2015-09-15 | 
| Last Update Date | 2023-10-03 |