| NPI | 1669933669 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 906649)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS R872661)  | 
| Enumeration Date | 2019-03-31 | 
| Last Update Date | 2025-03-13 |