| NPI | 1811728678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC F07240799) |
| Additional Taxonomies | 208VP0000X (Licence: NC 5021606) |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2025-08-19 |