| NPI | 1912678970 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 086621-23) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11015098) | 
| Enumeration Date | 2021-09-21 | 
| Last Update Date | 2023-10-12 |