| NPI | 1336625078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10020494) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A151156) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2025-07-03 |