| NPI | 1972844769 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07191) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN100743) | 
| Enumeration Date | 2013-03-05 | 
| Last Update Date | 2023-03-19 |