| NPI | 1912783051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 3-002118) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 27744) |
| Enumeration Date | 2023-09-05 |
| Last Update Date | 2025-09-17 |