| NPI | 1851142269 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND 202343) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1171330) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-04-01 | 
| Last Update Date | 2025-07-21 |