| NPI | 1225929144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AL 1-129660) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-129660) |
| Enumeration Date | 2025-07-10 |
| Last Update Date | 2025-07-14 |