| NPI | 1104415850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5022055) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: NC 264258) |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2025-08-25 |