| NPI | 1124800669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 240366) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 7671175) |
| Enumeration Date | 2023-10-18 |
| Last Update Date | 2025-10-13 |