| NPI | 1003244021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA 155058) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 155058) |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2025-11-18 |