| NPI | 1053855593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 85128) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM RN-75921) |
| Enumeration Date | 2016-12-16 |
| Last Update Date | 2026-01-28 |