| NPI | 1922240498 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1516A)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201050107NP)  | 
| Enumeration Date | 2009-03-31 | 
| Last Update Date | 2025-01-10 |