| NPI | 1134015399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5023449) |
| Enumeration Date | 2025-06-16 |
| Last Update Date | 2025-11-11 |