| NPI | 1740046176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN325452) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: LA 239948) |
| Enumeration Date | 2024-02-23 |
| Last Update Date | 2025-05-14 |