| NPI | 1659705507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 5663) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ND R39475) |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2025-10-29 |