| NPI | 1104612431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV 889229) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95034659) |
| Enumeration Date | 2025-04-15 |
| Last Update Date | 2025-08-13 |