| NPI | 1922721927 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: ND R42973) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ND R42973) | 
| Enumeration Date | 2022-09-23 | 
| Last Update Date | 2023-08-02 |