| NPI | 1750179875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5023417) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 2025002667) |
| Enumeration Date | 2025-04-28 |
| Last Update Date | 2025-12-09 |