| NPI | 1568280436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 906934) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN336869) |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2025-07-15 |