| NPI | 1104018969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011578) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 202489) |
| 374U00000X Home Health Aide (Licence: NC 202489) | |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2025-03-05 |