| NPI | 1962385575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MD R231124) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R231124) |
| Enumeration Date | 2025-07-30 |
| Last Update Date | 2025-08-22 |