| NPI | 1639762693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 2023210852) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-164298) |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2025-03-14 |