| NPI | 1376896423 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP02752) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM RN-75725) | 
| 225700000X Massage Therapist (Licence: NM 7085) | |
| Enumeration Date | 2012-10-25 | 
| Last Update Date | 2025-09-12 |