| NPI | 1922570118 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 58573)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11000742)  | 
| Enumeration Date | 2018-12-28 | 
| Last Update Date | 2020-06-25 |