| NPI | 1063233948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5022822) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 37089) |
| Enumeration Date | 2024-10-23 |
| Last Update Date | 2025-08-11 |