| NPI | 1013544576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 27319) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TN 27319) |
| 363L00000X Nurse Practitioner (Licence: TN 27319) | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2024-07-23 |