| NPI | 1356214811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025039619) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS TMP-163132) |
| Enumeration Date | 2025-09-29 |
| Last Update Date | 2025-09-29 |