| NPI | 1700675253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 53844) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID 53844) |
| Enumeration Date | 2025-05-01 |
| Last Update Date | 2025-08-21 |