| NPI | 1154119436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MT 283101) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT 273022) |
| Enumeration Date | 2025-04-28 |
| Last Update Date | 2026-04-29 |