| NPI | 1649669631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA H153070) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 153070) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2026-05-28 |