| NPI | 1013644962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5020058) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5020058) |
| 163W00000X Registered Nurse (Licence: FL RN9382877) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11021254) | |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2025-10-22 |