| NPI | 1831812502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R239546) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R239546) |
| 225700000X Massage Therapist (Licence: MD M06155) | |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2025-07-17 |