| NPI | 1669090783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013256) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5013256) |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2025-04-28 |