| NPI | 1407623762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 907785) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 891649) |
| Enumeration Date | 2023-12-07 |
| Last Update Date | 2025-10-03 |