| NPI | 1912793142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 240299) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: LA 240299) |
| Enumeration Date | 2025-04-15 |
| Last Update Date | 2025-08-07 |