| NPI | 1912650235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11017324) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 29620) |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2025-04-01 |