| NPI | 1912498593 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R26382) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND R26382) | 
| Enumeration Date | 2018-05-19 | 
| Last Update Date | 2022-03-16 |