| NPI | 1619518008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 10052209) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11003517) |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2026-02-17 |