| NPI | 1366903445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 44162) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 5244410-4405) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2025-05-07 |