| NPI | 1679234280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015866) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 308501) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5015866) | |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2025-09-04 |