| NPI | 1023669744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 24977) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176605) |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2019-09-24 |