| NPI | 1629684642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5013650) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 162986) |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2025-07-07 |