| NPI | 1649157520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 335454) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.419773) |
| Enumeration Date | 2025-08-20 |
| Last Update Date | 2026-03-12 |