| NPI | 1992355770 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24887) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201908676NP) | 
| Enumeration Date | 2019-09-13 | 
| Last Update Date | 2025-09-17 |