| NPI | 1073140752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024178748) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 27015) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2023-04-24 |