| NPI | 1346763901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 38905) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 0993308) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2026-03-24 |