| NPI | 1366204638 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 309643) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP029018) | 
| Enumeration Date | 2024-01-23 | 
| Last Update Date | 2025-07-01 |