| NPI | 1679329403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 2025044672) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 159932) |
| Enumeration Date | 2024-04-24 |
| Last Update Date | 2025-08-04 |