| NPI | 1003260191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 21086) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173715) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2025-02-17 |