| NPI | 1366282576 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5020799)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 306208)  | 
| Enumeration Date | 2024-05-28 | 
| Last Update Date | 2025-09-26 |