| NPI | 1194418582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 28003) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 353256) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2025-10-16 |