| NPI | 1891449443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A167083) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA A167083) |
| 207Q00000X Family Medicine (Licence: IA 1891449443) | |
| Enumeration Date | 2022-02-11 |
| Last Update Date | 2025-08-24 |