| NPI | 1790678274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 907756) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 924656) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2025-06-02 |
| Last Update Date | 2025-09-18 |