| NPI | 1053781708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AL AG0715073) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-077331) |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2026-07-23 |