| NPI | 1639858764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 291080) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 1571253) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2025-05-02 |