| NPI | 1326869942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA 4704400284) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704400284) |
| Enumeration Date | 2024-10-17 |
| Last Update Date | 2025-07-29 |